Hoffmann Sandra, Devleesschauwer Brecht, Aspinall Willy, Cooke Roger, Corrigan Tim, Havelaar Arie, Angulo Frederick, Gibb Herman, Kirk Martyn, Lake Robin, Speybroeck Niko, Torgerson Paul, Hald Tine
U.S. Dept. of Agriculture, Economic Research Service, Washington D.C., United States of America.
Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
PLoS One. 2017 Sep 14;12(9):e0183641. doi: 10.1371/journal.pone.0183641. eCollection 2017.
Recently the World Health Organization, Foodborne Disease Burden Epidemiology Reference Group (FERG) estimated that 31 foodborne diseases (FBDs) resulted in over 600 million illnesses and 420,000 deaths worldwide in 2010. Knowing the relative role importance of different foods as exposure routes for key hazards is critical to preventing illness. This study reports the findings of a structured expert elicitation providing globally comparable food source attribution estimates for 11 major FBDs in each of 14 world subregions.
We used Cooke's Classical Model to elicit and aggregate judgments of 73 international experts. Judgments were elicited from each expert individually and aggregated using both equal and performance weights. Performance weighted results are reported as they increased the informativeness of estimates, while retaining accuracy. We report measures of central tendency and uncertainty bounds on food source attribution estimate. For some pathogens we see relatively consistent food source attribution estimates across subregions of the world; for others there is substantial regional variation. For example, for non-typhoidal salmonellosis, pork was of minor importance compared to eggs and poultry meat in the American and African subregions, whereas in the European and Western Pacific subregions the importance of these three food sources were quite similar. Our regional results broadly agree with estimates from earlier European and North American food source attribution research. As in prior food source attribution research, we find relatively wide uncertainty bounds around our median estimates.
We present the first worldwide estimates of the proportion of specific foodborne diseases attributable to specific food exposure routes. While we find substantial uncertainty around central tendency estimates, we believe these estimates provide the best currently available basis on which to link FBDs and specific foods in many parts of the world, providing guidance for policy actions to control FBDs.
最近，世界卫生组织食源性疾病负担流行病学参考小组（FERG）估计，2010年全球31种食源性疾病导致超过6亿人患病，42万人死亡。了解不同食物作为关键危害暴露途径的相对重要作用对于预防疾病至关重要。本研究报告了一项结构化专家咨询的结果，该咨询为世界14个次区域中的每一个区域的11种主要食源性疾病提供了全球可比的食物源归因估计。
我们使用库克经典模型来引出并汇总73位国际专家的判断。从每位专家单独获取判断，并使用相等权重和绩效权重进行汇总。报告绩效加权结果是因为它们提高了估计的信息量，同时保持了准确性。我们报告食物源归因估计的集中趋势度量和不确定性界限。对于某些病原体，我们看到全球各次区域的食物源归因估计相对一致；对于其他病原体，则存在很大的区域差异。例如，对于非伤寒沙门氏菌病，在美国和非洲次区域，猪肉与鸡蛋和禽肉相比重要性较低，而在欧洲和西太平洋次区域，这三种食物来源的重要性相当相似。我们的区域结果与早期欧洲和北美食物源归因研究的估计大致一致。与先前的食物源归因研究一样，我们发现中位数估计周围存在相对较宽的不确定性界限。
我们首次给出了全球范围内特定食源性疾病归因于特定食物暴露途径的比例估计。虽然我们发现集中趋势估计周围存在很大的不确定性，但我们认为这些估计为世界许多地区将食源性疾病与特定食物联系起来提供了目前最好的基础，为控制食源性疾病的政策行动提供了指导。
